HLT07 Health Training Package V2.2 HLTEN608A Practise in the domiciliary health care environment Learner Resource Flexible delivery Version 2 Training and Education Support Industry Skills Unit Meadowbank Product Code: 5407
Acknowledgments The TAFE NSW Training and Education Support Industry Skills Unit, Meadowbank would like to acknowledge the support and assistance of the following people in the production of this learner resource guide: Writers: Kylie Brennan Lindy Cooper TAFE NSW Reviewers: Sue Brown TAFE NSW Project Manager: Di Dawbin Education Programs Manager TAFE NSW Acknowledgements are also given to all TAFE NSW teachers of the Enrolled Nurse Education Program. Enquiries Enquiries about this and other publications can be made to: Training and Education Support Industry Skills Unit, Meadowbank Meadowbank TAFE Level 3, Building J, See Street, MEADOWBANK NSW 2114 Tel: 02-9942 3200 Fax: 02-9942 3257 The State of New South Wales, Department of Education and Training, TAFE NSW, Training and Education Support Industry Skills Unit, Meadowbank, 2011. Copyright of this material is reserved to TAFE NSW Training and Education Support Industry Skills Unit, Meadowbank. Reproduction or transmittal in whole or in part, other than for the purposes of private study or research, and subject to the provisions of the Copyright Act, is prohibited without the written authority of, TAFE NSW, Training and Education Support Industry Skills Unit, Meadowbank. ISBN 978-1-74236-226-7 Developed by Training & Education Support Industry Skills Unit, Meadowbank TAFE NSW 2011
Table of contents Introduction... 7 1. General introduction... 7 2. Using this learner guide... 7 3. Prior knowledge and experience... 9 4. Unit of competency overview... 10 5. Assessment... 16 Topic 1 Domiciliary health care environment... 19 Topic 2 Topic 3 Topic 4 Underpinning philosophy of the domiciliary health care environment... 23 Revision of pathophysiology and physiology of clinical manifestations... 31 Physical, psychological and social impacts of health problems on daily living... 37 Topic 5 Identify actual or potential problem... 41 Topic 6 Assess impact of condition on client and family... 43 Topic 7 Topic 8 Topic 9 Collaborate with the registered nurse, client and family... 49 Consider client rights and advocacy when supporting health care needs... 53 Assist to monitor and evaluate client health care management... 61 Topic 10 Administer medications... 65 Topic 11 Community/in-hospital services available... 71 Topic 12 Skills... 73 Assessment requirements... 97 Reference list... 101 Developed by Training & Education Support Industry Skills Unit, Meadowbank TAFE NSW 2011
Topic 1 Domiciliary health care environment Domiciliary health care is provided to individuals and families in their homes or a place convenient to the client such as in schools, their work place or an ambulatory clinic. The goal of care is to reduce the premature need for the client to be admitted to an institution such as hospital or an aged care facility. Domiciliary nurses provide care across the age spectrum from the cradle to the grave. Within Australia domiciliary health care is more commonly referred to as home-based or community nursing although other terms have also been used such as district or ambulatory care nursing. Activity 1 a) List the health care settings where you think domiciliary nursing can occur. b) Identify the role of each health care setting. (Useful website: Healthy at Home program by NSW Health http://www.health.nsw.gov.au/initiatives/healthyathome/info_patients.asp) Page 19 of 108
Activity 2 Using the internet or relevant text book or other appropriate resources answer the following: 1. Explain the evolution of nursing in the community in Australia. 2. What is the difference between the roles of the District nurse and the Community nurse? District nurse: Community nurse: Page 20 of 108
Topic 2 Underpinning philosophy of the domiciliary health care environment The underpinning philosophy of domiciliary/home-based nursing is to promote the wellbeing and independence of clients, enabling them to remain in their homes longer. Over the last 20 years in Australia there has been a significant increase in home-based nursing services. Australia is shifting health services into the community and this will require more nurses to work in the community and provide care. These services are provided in conjunction with a number of other service providers. All members of the multidisciplinary health care team need to work effectively to ensure the best possible outcomes for the client and significant others. Members of the multidisciplinary team will need to communicate effectively with clients, groups and colleagues. They must participate actively and positively in client case meetings and have an understanding of family relationships and support networks and community services available. Activity 1 a) Why do you think there has been such an increase in health services provided in the community? Page 23 of 108
A multidisciplinary team approach is the most useful way in managing the multifaceted problems of clients in their homes and other health care settings. Members of the multidisciplinary health care team who could be involved in domiciliary care include: client and their significant others medical staff including specialist services such as palliative care, psychiatric services nursing staff including specialist services such as palliative care, psychiatric services counsellors: social workers, psychologists allied health workers: physiotherapists, occupational therapists, speech pathologists, dietician prosthetists podiatrists drug and alcohol services emergency services including ambulance, Royal Flying Doctor Service, CareFlight community services such as Home Care, Meals on Wheels, Community Options transitional rehabilitation services. Page 25 of 108
Activity 3 Complete the table on the following pages by highlighting how the role of the member of the multidisciplinary health care team involved in domiciliary/home-based nursing listed above, differs from their roles in a hospital environment. MEMBERS HOME/COMMUNITY HOSPITAL Client and their significant others Medical staff including specialist services such as palliative care, psychiatric services Nursing staff including specialist services such as palliative care, psychiatric services Counsellors: social workers, psychologists Physiotherapists Page 26 of 108